The pathogenesis of Kaposi's sarcoma is unknown. Human immunodeficiency virus (HIV) itself is a cofactor in patients with AIDS, as suggested by the induction of Kaposi's sarcoma.
Kaposi's Sarcoma is characterized by multifocal, widespread lesions at the onset of the disease. Intraoral lesions may occur either alone or in association with skin, visceral and lymph node lesions. Frequently the first lesions of Kaposi's sarcoma appear inside the mouth. The gingival lesions may be associated with considerable gingival enlargement causing periodontal pocketing. 3. Kaposi's sarcoma associated with renal transplant. This form occurs in transplant recipients undergoing immunosuppressive therapy. The lesions often regress when immunosuppressive therapy is discontinued. The plaque stage lesions may eventually enlarge and become nodules (nodular stage). The plaque and nodular stage lesions may be red, violet, pink, brown or various combinations of these colors.
In approximately 26% of homosexual men with AIDS, Kaposi's sarcoma is present at the time of diagnosis or develops during the course of the disease. In contrast, Kaposi's sarcoma develops in only about 3% of heterosexual intravenous drug abusers with AIDS. Plaque and nodular stage lesions may be confused clinically with AIDS-related angiomatosis, hemangiomas, pyogenic granulomas, nevi, melanomas, cutaneous lymphomas, and angiosarcomas.
Patients with localized, epidemic Kaposi's sarcoma are treated with local modalities such as surgical excision, electrocautery, curettage, or radiation therapy. The lesions sometimes recur several months after treatment. Surgical debulking may be successful for small lesions.
